Heart Attack, Panic Attack, Anxiety and Indigestion: What is the Difference?

Learn why symptoms feel so similar, how to tell them apart and when to seek care

Chest pain or tightness, burning sensations, shortness of breath, sudden sweating – any of these can be heart attack symptoms, but they also may indicate something less serious. Other common causes of chest pain include a panic attack, anxiety attack and indigestion. Learn how to tell these symptoms apart and when to seek care.

Heart attack
The most well-known heart attack symptoms include chest pain and tightness, pain in the jaw, shoulder or arm, sweating and shortness of breath. In women, heart attack symptoms may be more subtle.
“Both men and women may have chest pain and shortness of breath during a heart attack, but women also may have nausea, significant fatigue, lightheadedness or an upset stomach that starts up to a month before,” says Todd Hitchcock, MD, a cardiologist at Scripps Clinic Carmel Valley.
Chest pain from a heart attack is severe and sudden and typically happens with other symptomslike shortness of breath, profuse sweating and nausea. If you experience these symptoms, call 911 or go the emergency department. Don’t wait to see if you feel better or if the symptoms go away. Even if it is not a heart attack, emergency medical professionals would prefer that you be safe than sorry.
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Panic attack
A panic attack is an unexpected, sudden and often overwhelming feeling of fear, impending danger or loss of control that often seems to come out of nowhere. Panic attack symptoms can feel very similar to a heart attack and may include chest tightness, difficulty breathing, a pounding or racing heart, nausea, sweating and trembling. However, unlike heart attack symptoms, panic attack symptoms usually do not include severe chest pain or pain in the neck or arms. Panic attack symptoms may last for 10 to 20 minutes or go away as quickly as they came.
Panic attacks tend to happen more than once and can occur a few times a year or several times a week; people who experience frequent panic attacks often have panic disorder. If you experience symptoms of a panic attack and have never had one before, it is a good idea to go to an emergency room to make sure it is not something more serious. Despite their similar symptoms, it can be reassuring to know that a panic attack cannot lead to heart attack.
If panic attacks happen often, learning calming techniques to manage them can be very helpful. Counseling and behavior changes can help control frequent panic attacks; sometimes, simply acknowledging what is happening and taking deep, focused breaths can reduce symptoms. Other treatments for panic attacks include therapy or medication.

Anxiety attack
An anxiety attack may feel much like a panic attack, but there are differences. Both panic and anxiety attack symptoms may include a rapid heart rate, shallow breathing, nervousness, sweating and trembling, but panic attack symptoms tend to be more intense and pass more quickly. Symptoms of an anxiety attack typically last longer – often for days or weeks.  
Panic attacks usually seem to happen for no reason, while anxiety attacks generally occur in response to a specific threat or stressful event. Also, unlike a panic attack, feelings of anxiety tend to increase slowly over time, ultimately leading to an anxiety attack.
Treatments for anxiety attacks are similar to those for panic attacks. Recognizing and acknowledging that you are having an anxiety attack can help reduce nervousness, as can relaxation techniques. Therapy or medication may help treat recurring anxiety attacks.

Indigestion
Indigestion symptoms include pain, burning or discomfort in your upper abdomen, so they may feel like they’re in your chest. Also called heartburn or acid reflux, indigestion usually occurs after a meal, especially if you are sensitive to rich or spicy foods or eat more than usual.Indigestion may respond to changes diet and activity after eating.

“However, some symptoms of a heart attack may feel like indigestion, especially among women,” says Dr. Hitchcock. “If your acid reflux symptoms seem associated with activity or exertion rather than food or drink, you should get checked for cardiac issues just to be on the safe side.”

If you develop new or concerning chest pain, adds Dr. Hitchcock, always go to the emergency department – it’s best to get checked out when your symptoms are active.

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